The scope and impact of tobacco industry direct mail, a frequently utilized industry marketing strategy, has thus far received limited attention and research from tobacco control. Research in this area has been hampered by the very nature of direct mail as a non-public source of marketing with limited visibility, the difficulty of directly observing its influence on receivers'smoking behaviors, and by the lack of existing data establishing its magnitude and importance. As a direct-to-consumer marketing technique, direct mail goes straight to the homes of those on the industry's extensive mailing lists and so operates largely out of the sight of the general public and under the radar of tobacco control, public health, and regulatory agencies. Nor is the influence of direct mail and the incentives it carries (e.g., coupons, gifts) on smoking behavior easily observed. To date, no national-level data are available and research aimed at establishing its role in tobacco use behavior has been almost nonexistent. This proposal responds to NIH Program Announcement, PA-09-130 and describes a plan to address gaps in the knowledge base regarding prevalence of direct mail marketing and its influence on tobacco behaviors. Accordingly, we will: 1) conduct focus groups to understand smokers'perceptions of tobacco industry direct mail to inform survey development, 2) develop and refine a survey instrument, which will undergo conduct cognitive testing, to assess participation in direct mail and its potential impact on smoking behavior, 3) conduct a nationally representative population-based web survey of adult cigarette smokers to determine the prevalence of direct mail receipt and understand its impact on smoking behavior, and 4) identify areas of possible intervention and/or specific counter strategies to address the influence of direct mail on tobacco use behavior based on the analysis of qualitative and quantitative data collected. Thus, the significance of this proposed research is its potential to generate a better understanding of direct mail and how it is perceived by its recipients which is vital to informing and directing counter marketing strategies. This knowledge will contribute to the evidence base for further research and initiatives to counter the influence of tobacco industry direct mail. PUBLIC HEALTH RELEVANCE: The purpose of this research project is to better understand the scope of tobacco industry direct mail marketing and its impact on smokers. The relevance of the proposed research to public health is its ability to address important gaps in knowledge of direct mail and how it is perceived by its recipients which is vital to informing and directing counter marketing strategies.